Quebec is slowly moving towards legal, or quasi-legal, euthanasia. A committee of legal experts has delivered a 400-page report to the provincial government which argues that it should allow “medical assistance to die” when a patient is close to death is suffering from unbearable physical or psychological pain. (A summary of the report is available in French, but the whole report has not been released yet.)

There is a hitch, however. The problem is that Canada is a federation whose criminal code forbids euthanasia and assisted suicide. But the experts claim that they have found a loophole.

Quebec junior health minister Veronique Hivon says that provinces have jurisdiction over health and that Quebec would pass legislation which would redefine suicide. "The constitutional basis is clear," she says. "We are really in a field of regulating end-of-life care — and adding the possibility for somebody to have access to medical aid in dying." She hopes to table a bill before the legislature adjourns for the summer.

The framework for euthanasia would work as follows. A patient would make a written request on the basis of unbearable physical or psychological suffering. He or she would have to confirm this request and two doctors would have to approve the request. A new law would effectively state that withdrawal of care or the application of a terminal sedative in these circumstances is appropriate medical care and not a suicide. Therefore the doctors could not be charged with killing the patient.

The legal gymnastics are interesting. A summary of the report says that “a new kind of care” will be invented by the law, presumably bypassing the medical textbooks:

“Finally, a new kind of care would be introduced which is part of the continuum of end of life care or medical assistance to die. The proposed rules are also part of the ongoing development of human rights at the end of life.”

Hospitals and associations of doctors would be asked to change their codes of ethics to include euthanasia and assisted suicide.

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